Diabetes mellitus is a disease of carbohydrate metabolism caused by lack of insulin, characterised by an abnormaly elevated level of blood glucose and the excertion of the excess glucose in the urine. It results from an absolute or relative lack of insulin which leads to abnormalities in carbohydrate metabolism as well as in the metabolism of protein and fat.

Diabetes occurs in all age groups, from young infants to the elders, although it occurs rarely below the age of two years. There are, however, differences between the disease as it occurs in children and young adults, as against the middle aged and elderly. There is growing evidence that juvenile diabetes mellitus may be associated with environmental factors.

Symptoms

The onset of diabetes in children is acute or sub-acute. The history of illness varies from a few hours to a few weeks. The course of the disease may be so rapid that sometimes the child gets medical treatment for the first time only after coma has developed. Early common symptoms are thirst and a passage of a great deal of urine, which may cause bed-wetting. The child may lose energy and weight. He may complain of abdominal pain or vomiting. Once vomiting has started, dehydration and acidosis can develop quickly.

The child becomes thin and may have a respiratory or other infection. The skin and tongue may be dry and breath sweet smelling. Ketoacidosis occurs readily in childhood diabetes. In advanced stage, the pulse is weak and rapid and the blood pressure is low. The child-patient may become drowsy and may go in to a state of semiconciousness or unconsciousness.

Causes

Heredity plays an important role in the development of diabetes in children, but it alone cannot cause the disease. According to the American Diabetes Association, recent research indicates that certain viruses may combine with an inherited susceptibility and may lead to diabetes. Of the 15 million Indians who have diabetes, many cases began in childhood or adolescence.

Many cases of diabetes in children under the age of 15 years appear suddenly. Unlike adults, this diabetes in children has little to do with weight. The diabetic child may contribute to his comfort, but this factor alone cannot stabilize the sugar level.

Treatment

Any successsful method of diabetes treatment should aim at removal of the actual cause of the disease and building up of the whole health level of the patient. Diet plays a vital role in such a treatment. Fruits, nuts and vegetables, whole meal bread and dairy products form a food diet for the diabetic. These foods are best eaten in as dry a condition as possible to ensure thorough ensalivation during the first part of the process of digestion. Cooked starchy foods should be avoided.

The diabetic should not be afraid to eat fresh fruits and vegetables which contain sugar and starch. Fresh fruits contain sugar fructose, which does not need insulin for its metabolism and is well-tolerated by diabetics. Fats and oils should be taken sparingly, for they are apt to lower the tolerance for proteins and starches. Emphasis should be on raw foods as they stimulate and increase insulin production. For protein, homemade cottage cheese, various forms of soured milk and nuts are best. The patient should avoid overeating and take four or five small meals a day rather than three large ones.

Celery,cucumbers, string beans, onins and garlic are especially beneficial. String bean pod tea is an excellent natural substitute for insulin and highly beneficial in diabetes. The skin of the pods of green beans is extremely rich in silica and certain hormone substances which are closely related to insulin. One cup of string bean tea is equal to one unit of insulin. Cucumbers contain a hormone needed by the cells of the pancreas for producing insulin. Onion and garlic have proved beneficial in reducing blood sugar in diabetes.

Recent scientific investigations have established that bitter gourd (karela) is highly beneficial in the treatment of diabetes. It contains an insulin -like principle, known as plant-insulin which has been found effective in lowering the blood and urine sugar levels. It should therefore, be included liberally in the diet of the diabetic. For better results, the child patient should take juice of one or two fruits every morning on an empty stomach. It can also be used in the form of decoction by boiling the pieces in water or in the form of dry powder.

Indian gooseberry (amla) with its high vitamin C content, is considered valuable in treating diabetes. A teaspoon of its juice, mixed with half a cup of bitter gourd (karela) juice, taken daily for two months will stimulate the islets of Langerhans, i.e. the isolated group of cells that secrete the hormone insulin. It thus reduces the blood sugar level in diabetes.

Jambul fruit (jamun) is another effective home remedy. It is regarded in traditional medicine as a specific against diabetes because of its effect on the pancreas. The fruit, the seeds and fruit juice are all useful in the treatment of this disease. The seeds contain a glucoside ‘jamboline’ which is believed to have the power to check the pathological conversion of starch into sugar in cases of increased production of glucose. They should be fried and powdered. This powder should be taken in doses of three to six grams by the child mixed in milk, curd of water.

The child patient should avoid tea,coffee and cocoa because of their adverse influene on the digestive tract. Other foods which should be avoided are white bread,white flour products, sugar, tinned fruits, sweets, chocolates, pastries, pies and refined cereals.

The most imortant nutrient in the treatment of diabetes is manganese which is vital in the production of natural insulin. It is found in citrus fruits, in the outer covering of nuts,grains and in the green leaves of edible plants. Other nutrients of special value are zinc, B-complex vitamins and poly-unsaturated fatty acids.

Fresh air exercies are also an important factor in the treatment of diabetic child. Light games, Jogging and swimming are recommended. Yogic asanas such as bhujangasana, shalabhasana, dhanurasana, paschimottanasana, sarangasana, halasana and shavasana, yogic kriyas like jalaneti and kunjal and pranayam such as kapalbhati, anuloma-viloma and ujjai will be beneficial and the grown-up children should be encouraged to undertake these practices regularly.

Bathing in cold water greatly increase the circulation and enhances the capacity of the muscles to utilise sugar. The diabetic should eliminate minor worries from his daily life. He must endeavour to be more easy-going and should not get unduly worked up by stress, strain of life.